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When Basil Tavake left his home in the Solomon Islands on Dec. 31, he was excited for his chance to study abroad at the University of Hawaii Hilo.

But within weeks of leaving, the Solomon Islands experienced its first Covid-19 outbreak since the pandemic began some two years ago.

The number of confirmed cases quickly ballooned to more than 7,000, overwhelming health care workers and leading to dozens of deaths in a country of about 700,000 people.

Now Tavake spends every day refreshing Facebook to see the latest updates. Daily case counts have begun to fall, but he’s worried that the coronavirus will spread to his home province.

The Solomon Islands is among several Pacific nations and territories that have been Covid-free for most of the pandemic but recently experienced their first surges, as the coronavirus crisis appears to be ebbing in Hawaii and other U.S. states, allowing them to relax restrictions.

Marking a milestone this week, Hawaii announced it will end its Safe Travels program that has required travelers to show proof of vaccination or a negative Covid test to avoid an otherwise mandatory quarantine. Honolulu and other counties also are lifting local restrictions, although Hawaii remains the only state to maintain an indoor mask requirement.

Sean Casey, Pacific Covid-19 incident manager at the World Health Organization, said Pacific countries have been some of the last places in the world to escape the pandemic due in part to strict border controls. Now for several communities that’s no longer the case.

“Quite a few of them in the last few weeks have had their first cases and their first community transmission,” he said. That’s not necessarily because they’re opening their borders. As the virus has evolved to become more transmissible, some Pacific communities are seeing more maritime cases or spillover cases from quarantine, he said.

American Samoa went under lockdown last week after detecting its first cases of community spread, prompting the Federal Emergency Management Agency . Palau and Kiribati both experienced their first Covid surges in January, and the Cook Islands . Not all the surges are new — some countries like Fiji are in the midst of their third wave.

The found that in the week ending Monday, Pacific Covid cases made up more than a third of new coronavirus cases worldwide despite their relatively small populations.

That week, more than 1.3 million new Covid cases were recorded in the western Pacific, compared with fewer than 500,000 in the Americas. Only Europe had a higher number of cases at over 1.8 million. Thousands of the cases were in New Zealand, where Pasifika communities have been .

Border Closures Bought Time To Vaccinate

Many Pacific countries and territories shut themselves off from Covid when the pandemic started in early 2020, fearful of how the virus would strain their limited health infrastructure and how their communities’ high rates of other conditions like diabetes and hypertension might increase their risk of deaths.

Border closures protected places like the Solomon Islands and other islands from the first strain of Covid and bought time to implement vaccination campaigns. But they also came at a high cost — evaporating tourism revenue, increasing unemployment and stranding hundreds of citizens abroad.

January’s destructive tsunami in Tonga prompted international aid workers to come into the kingdom,

Crystal Kionia, a community organizer in Hawaii who spent part of her childhood in Tonga and has family there, hopes the kingdom’s borders will remain closed to prevent more Covid from spreading.

She’s particularly concerned about members of her family who have medical conditions that make them more vulnerable to Covid.

Kionia has launched  and planned a disaster relief event in Honolulu on Saturday to collect masks and other protective equipment to send to the islands.

One silver lining is the fact that Tonga has a high vaccination rate, with more than 157,000 doses administered to the country’s population of just over 100,000, according to the WHO.

Casey from the WHO said high vaccination rates are one way that Pacific countries have succeeded during the pandemic.

More than 98% of Palau’s population is fully vaccinated against Covid, and 60% received a booster shot, according to .

An estimated 99.9% of the population in the Northern Mariana Islands is vaccinated,

In Tonga, vaccination outreach has been so focused that the country has actually been keeping track of eligible individuals and making an effort to reach every last one to make sure they get vaccinated, Casey said.

Booster shots still lag behind there. Tongan news outlet that 40% of the eligible population has received booster doses compared with 97% who received initial shots.

Human Cost

While many Pacific nations and territories have an adequate supply of vaccines, getting the vaccines to the people who need them hasn’t always been easy.

In the Solomon Islands, the logistics of vaccinating people who live in rural areas are challenging, says Tarcisius Kabutaulaka, an associate professor and former director of the University of Hawaii Center for Pacific Island Studies who is from the Solomon Islands.

Then there’s the misinformation about the vaccine that’s spread fear and contributed to the Solomon Islands having just about 300,000 vaccine doses administered, compared with their population of about 700,000, according to the WHO.

Tavake believes the government is doing its best to respond but knows there’s not enough health infrastructure to meet the need.

“If Covid-19 reaches my province, it will be very difficult to access health care,” the University of Hawaii student said.

Kabutaulaka has spent part of the last few weeks interviewing health care workers in his home country about their exhaustion, frustration and stress during the surge. The situation is getting better now at the country’s main hospital as cases fall, but rural communities are still a concern.

What’s missing from much of the coverage of the crisis is the human cost of the surge, Kabutaulaka says.

“In the last couple of weeks nearly every day somebody I know or knew passed away,” he said. “This is really traumatic.”

There was the friend who had asked Kabutaulaka to visit just two weeks before he died. The husband and wife who each died within days. Another friend of Chinese ancestry who died a day after burying his mother.

One difference between Covid in Pacific countries with small populations and the U.S. is how personal the pandemic feels, he said.

“In the U.S. you hear of people dying and they’re probably people you don’t know,” he said. In communities like the Solomon Islands, the Covid mortality rate is not a vague statistic — it is made up of “people you know, people you went to school with, people you drink cava with.”

Civil Beat’s health coverage is supported by , Swayne Family Fund of Hawaii Community Foundation, Cooke Foundation and .